dementia, driving & California state law

Introduction

A California state mandate requires physicians to submit a confidential report to the county health department when an individual is diagnosed as having a dementing illness. This information is forwarded to the department of motor vehicles (DMV). The DMV has determined that drivers with mild dementia may still have the cognitive function to continue to drive safely; however, individuals with moderate to severe dementia will not be able to safely operate a motor vehicle.

The DMV uses the following guidelines when a medical report is received.

• A computer search is conducted to locate the individual's name, verify that he/she has a driver's license & examine the driving record.
• The individual is contacted by letter & sent a 'Driver Medical Evaluation' form to authorize his/her primary physician to submit medical information about the status of dementia to the DMV.
• The medical form is reviewed by a Driver Safety hearing officer. If the documentation indicates the dementia is mild, the individual is scheduled for a reexamination with the DMV. If the individual is moderately or severely demented, his/her driving privileges will be revoked. If the individual fails to submit the medical documentation within 26 days, all driving privileges will be suspended.
• The reexamination involves 2 phases: written test & interview
  • written test
    • the individual is given the standard DMV written examination designed to test a person's knowledge of traffic laws
    • the written test allows the DMV to determine not only the individuals knowledge of driving laws, but the individual's mental competency & cognitive & language skills
  • interview
    • a face to face interview focuses on the medical documentation as well as the induvidual's long-term & recent memory of events
  • persons who do well on the written test & interview are then given a driving test
  • persons who do poorly on the written test or interview may have their driving privileges suspended or revoked
• The driving test is designed to test driving skills that might be affected by mild dementia. The 1st observation is whether or not the individual can find his/her car. Then, the examiner gives a series of commands, rather than 1 direction at a time. For example, the instructions might be: 'Please drive to the corner, turn left, then turn right on the 1st street.' The test generally lasts longer than the ordinary driver's test in order to assess whether fatigue is a problem.
• If the individual passes the driving test, the license is generally not suspended. Generally restrictions will be imposed on the license, such as no freeway driving, no night driving, or may only drive within a certain radius. The DMV will want to review the individual's driving skills again in 6-12 months. At that time, the entire process begins again.
• An appeals process is available if the individual or family wishes to contest the suspension of the driver's license. At the hearing, the individual must present evidence, such as new medical information, to prove that the dementia does not impair his/her ability to safely operate a motor vehicle.
• The DMV can provide a California identification card to those persons who will no longer have a driver's license.

The DMV has separate requirements & guidelines for drivers with other cognitive disorders (e.g. stroke, head injury, seizures).

Additional terms

• assessment of older drivers
• dementia; Alzheimer's disease & related dementias (ADRD)
• department of motor vehicles (DMV)